Objective To evaluate the cognitive dysfunction and its influential factors in patients with symptomatic and asymptomatic lacunar infarction(LI). Methods Mini-mental state examination (MMSE), MoCA and P300 were carried out among 70 patients with first attack of LI 1 week after, 66 patients with asymptomatic LI and 54 patients for control at first visit. The tests were performed again in the follow-up of half a year and one year. Results (l)The scores of MMSE and MoCA at 1 week, half a year and one year of LI at acute stage were lower than asymptomatic LI(P＜0. 01) and control group(P＜0. 01). Latent periods of P300 at each time point were longer than those in patients with asymptomatic LI (P＜0. 05) and control group (P＜0. 01). (2)The scores of MMSE and MoCA at first visit, half a year of follow-up and one year of follow-up in patients with asymptomatic LI were lower than those in control group(P＜0. 01), and the latent period of P300 was longer than that in control group(P＜0. 01). (3)The scores of MMSE and MoCA at 1 week of LI at acute stage and first visit of asymptomatic LI were higher than those after one year(P＜0. 05). The latent periods of P300 were shorter than those after one year(P＜0. 05). Compared with those half a year after, MMSE and MoCA one year after decreased more and the latent period of P300 prolonged(P＞0. 05). (4) The scores of MoCA in the aspects of visuospatial and executive function, abstract thinking and attention were lower than those in control group (P＜0. 01). (5)The score of MoCA in LI patients with multiple foci was lower than that in LI patients with single focus(P＜0. 01). The scores of MoCA in patients with foci in basal ganglia, frontal lobe, temporal lobe and thalamus were lower than those in patients with foci in other parts (P＜0. 01). Conclusion LI (both symptomatic and asymptomatic) is easily accompanied with cognitive dysfunction. The cognitive damage becomes more severe as time prolongs. The common symptoms include damages of visuospatial and executive function, abstract thinking and attention. Patients with multiple foci and with LI in key parts easily suffer from cognitive dysfunction. Thus, it needs to evaluate and prevent early.

Objective : To observe the effects of brain-computer interface-controlled pedal training system on bal- ance function and serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels in ischemic stroke pa- tients． Methods : Forty patients with ischemic stroke who were hospitalized from September 2022 to September 2023 were selected as observation subjects．The patients were equally divided into stroke control group and stroke experimental group according to the random number table method．At the same time，20 healthy subjects with similar gender and age were recruited as the healthy control group to collect relevant plantar pressure data．Patients in the stroke control group received conventional rehabilitation training including the upper and lower extremity active and passive motor training system，and the stroke experimental group replaced the upper and lower extremity active and passive motor training system in the stroke control group with the brain-computer interface-controlled pedal training system for rehabilitation treatment，and other things remained unchanged．Bilateral plantar pressure symmetry index (SI) and center of body pressure ( COP) swing area were collected from both groups of stroke patients with eyes open and closed using the plantar pressure assessment system before and after 4 weeks of treatment．Fugl-meyer low- er extremity motor function score (FMA-LE) and berg balance scale (BBS) were used to evaluate the two groups of stroke patients．Serum IL-6 and TNF-α levels were also compared between the two groups before and after treat- ment. Results : ① The SI value and COP swing area in the eyes open and closed state improved in both groups of stroke patients after treatment compared with that before admission，and the results of the stroke experimental group were better than those of the stroke control group (P ＜0. 05) ，but there was still a gap with the healthy control group (P＜0. 05) . ② The BBS and FMA-LE scores of stroke patients in both groups were higher after treatment than before treatment，and the scores of the stroke experimental group were greater than those of the stroke control group，with statistically significant differences (all P＜0. 05) . ③ Serum IL-6 and TNF-α levels decreased in both groups of stroke patients after treatment compared with before，and the degree of decrease in serum IL-6 and TNF-α levels in the stroke experimental group was greater than that in the stroke control group，and the difference was sta- tistically significant (P＜0. 001，P＜0. 05) ． Conclusion Brain-computer interface-controlled pedal training sys- tem has a facilitating effect on the recovery of balance function in hemiplegic patients with ischemic stroke，and its mechanism may be related to the reduction of serum IL-6 and TNF-α levels.

Background A large amount of iron deposition in the brain can cause neuronal damage by inducing oxidative stress, neuroinflammation, and abnormal mitochondrial function. In addition, iron deposition is also reported to be closely related to the pathogenesis of Alzheimer's disease (AD). The neurofibrillary tangles aggregated by tau hyperphosphorylation are one of the important pathological features of AD. Objective To investigate potential effect of exogenous trivalent iron ions on neuronal activity in human neuroblastoma (SH-SY5Y) cells and tau hyperphosphorylation and aggregation. Methods SH-SY5Y cells were treated with ferric chloride (FeCl₃) at four concentrations (10, 100, 200, and 400 mg·L⁻¹). Cell survival rate was then detected by CCK8 assay. Intracellular iron content was determined prussian blue (Perl's) by iron staining after 24 h exposure to FeCl₃ at 10 or 200 mg·L⁻¹. Transfection of tau-P301L plasmid was conducted to construct an AD-like cell model for tau overexpression. The differences in the expression of the phosphorylated tau (p-tau) protein in SH-SY5Y cells and SH-SY5Y cells with tau overexpression were detected by Western blotting after 24 h exposure to FeCl₃ at 10 and 200 mg·L⁻¹. After dilution with phosphate buffered saline (PBS), FeCl₃, human tauR3, and FeCl₃ + tauR3 were incubated at 37℃, and the fluorescence intensity reflecting tau aggregation level was measured by thioflavin T(ThT) method at 12, 24, 36, 48, 60, 72, 84, and 96 h, respectively. Meanwhile, after 96 h coincubation of FeCl₃ and tauR3, the fibers formed by tau aggregation were observed under a transmission electron microscope (TEM). Results After 24 h of FeCl₃ exposure, the cell survival rate of SH-SY5Y cells among all groups was statistically different (F=8.63, P<0.01). The cell survival rates in the 200 and 400 mg·L⁻¹ groups were 80.1% and 68.7% of the control group, respectively (P<0.05). Compared with the control group, the nuclei of the 200 mg·L⁻¹ FeCl₃ group were mainly yellowish-brown after iron staining and the positive cell rate was up-regulated by 12.9% (P<0.01). After 24 h of FeCl₃ exposure , the p-tau (Ser396) protein expression was statistically different among all groups (F=11.6, P<0.01). Compared with the control group, the p-tau protein expression level of SH-SY5Y cells in the 200 mg·L⁻¹ group was up-regulated by 72.7% (P<0.01). After FeCl₃-treated SH-SY5Y cells with tau overexpression for 24 h, the p-tau (Ser396) protein expression was statistically different among all groups (F=27.8, P<0.01). Compared with the tau group, the p-tau (Ser396) protein expression level of SH-SY5Y cells in the tau + 200 mg·L⁻¹ group was up-regulated by 44.6% (P<0.05). Compared with the tauR3 group, the fluorescence intensities in the 84 and 96 h tauR3 + FeCl₃ groups were up-regulated by 49.9% and 53.7% (P<0.01) respectively. After 96 h of coincubation, compared with the tauR3 group, FeCl₃ + tauR3 aggravated tau aggregation and formed fiber deposition under TEM. Conclusion Exogenous trivalent iron ions may inhibit SH-SY5Y cell viability, promote the phosphorylation of tau in SH-SY5Y cells transfected with tau-P301L plasmid, and aggravate tauR3 aggregation and fiber production.